RESUMO
Detection of specific IgE by the radioallergosorbent test (RAST) which uses labelled antibody can be hampered by the presence of antibodies other than IgE but with the same specificity and may limit usefulness of the RAST for diagnosis of IgE-mediated milk allergy in infancy when high titres of cow's milk protein-specific IgG antibodies are known to be present. This can be avoided by using a system employing labelled antigen, such as the enzyme-linked immunosorbent assay (ELISA) described here, where IgE in the test serum is immunoadsorbed to anti-human IgE coated to microtitre plates. Biotinylated antigen, in this case cow's milk proteins, binds to specific IgE and the reaction is revealed colorimetrically by adding horseradish peroxidase (HRP)-avidin conjugate.
Assuntos
Imunoglobulina E/análise , Proteínas do Leite/imunologia , Animais , Avidina , Biotina , Bovinos , Ensaio de Imunoadsorção Enzimática/métodos , Humanos , Imunoglobulina G/análise , Lactente , Recém-Nascido , Teste de RadioalergoadsorçãoRESUMO
To date, corticospinal tract functional integrity in ataxia-telangiectasia has not been studied. Thorough evaluation of central motor pathways is also lacking in neuropathologic and clinical studies. Using electromagnetic stimulation, we assessed the integrity of the corticospinal tracts in eight patients with ataxia-telangiectasia. Cortical and peripheral compound motor action potentials were recorded from the abductor pollicis brevis muscle. Recordings of the shortest F-wave latency and of the compound motor action potential distal latency were made from the abductor pollicis brevis muscle after electrical stimulation of the median nerve at the wrist. A significant increase in central motor conduction time was observed in four patients, two of whom had clinical findings compatible with a pyramidal lesion. This study demonstrates involvement of the central motor pathways in ataxia-telangiectasia, which appears to be more frequent late in the course of the disease.
Assuntos
Ataxia Telangiectasia/fisiopatologia , Tratos Piramidais/fisiopatologia , Adolescente , Fatores Etários , Criança , Pré-Escolar , Estudos Transversais , Eletromiografia , Eletrofisiologia , Feminino , Humanos , Masculino , Nervo Mediano/fisiopatologia , Condução Nervosa/fisiologia , Tempo de Reação/fisiologia , Nervo Sural/fisiopatologiaRESUMO
The results obtained using a new in vitro screening test for atopy Phadiatop-paediatric (Phad-P) and RAST for multiple food and inhalant allergens in 132 children (82 with atopic dermatitis and 50 with a negative history of atopic symptoms are compared. 64% of the subjects were RAST-positive for food allergens (55/82) in those with dermatitis and only 5/50 in those without atopic symptoms. The only difference between the new test and the RAST is that a mixture of food and inhalant allergens, rather than a single allergen, is conjugated to the paper disk and the results are expressed as positive or negative so as to identify atopic subjects for further allergologic evaluation. The sensibility and specificity of Phad-P as compared to RAST were respectively 87% and 85% with an efficiency of 86%. On the basis of these data, assuming a 20% prevalence of atopy, in the general population the predictive value of negative results of the new test would be 97% and of positive results 59% with an expected efficiency of 86% values similar to those observed in other studies and at the moment considered satisfactory for a screening test fo atopy.
Assuntos
Alérgenos , Hipersensibilidade Imediata/diagnóstico , Imunoglobulina E/sangue , Teste de Radioalergoadsorção , Especificidade de Anticorpos , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Dermatite Atópica/diagnóstico , Dermatite Atópica/epidemiologia , Estudos de Avaliação como Assunto , Feminino , Humanos , Hipersensibilidade Imediata/epidemiologia , Lactente , Masculino , Teste de Radioalergoadsorção/estatística & dados numéricos , Sensibilidade e EspecificidadeRESUMO
An 11-year old girl who presented non-pitting edema of the face and neck, shoulder pain and a gallop rhythm about 10 days after a febrile episode with sore throat is described. The mask-like facial appearance and limited movement of the neck led to suspect scleredema which may be accompanied by carditis. Skin and muscle biopsy findings confirmed the diagnosis. Cardiac involvement included a gallop rhythm persisting for 6 months, ECG changes consisting in transitory T-wave inversion in leads II and V2 - V4, a transitory pericardial function rub and hepatomegaly due to right-sided failure which responded to digitalization. In this case the presence of a gallop rhythm and elevated ASLO titer led to an initial diagnosis of acute rheumatic fever; dermatomysitis and sclerodermia are also to be considered in the differential diagnosis of scleredema of Buschke. In our patient the edema resolved completely within 12 months, the gallop rhythm within 6 months and the ECG became normal after 8 months.
Assuntos
Arritmias Cardíacas/complicações , Escleredema do Adulto/complicações , Criança , Feminino , Humanos , Escleredema do Adulto/patologiaRESUMO
The various "in vitro" tests for evaluating polymorphonuclear leucocyte function in children with recurrent infections are described and the different clinical conditions caused or accompanied by defects in polymorphonuclear function are summarized briefly. The necessity of correct interpretation of the results of the laboratory tests used in the diagnostic evaluation of patients with suspected immunodeficiency is stressed.
Assuntos
Agranulocitose/diagnóstico , Disfunção de Fagócito Bactericida/diagnóstico , Inibição de Migração Celular , Criança , Dermatite Atópica/imunologia , Humanos , Neutrófilos/imunologia , Neutrófilos/metabolismo , Nitroazul de Tetrazólio , Fagocitose , Recidiva , Infecções Estafilocócicas/imunologiaAssuntos
Amino Álcoois/uso terapêutico , Analgésicos/uso terapêutico , Codeína/uso terapêutico , Adolescente , Adulto , Idoso , Análise de Variância , Ensaios Clínicos como Assunto , Humanos , Masculino , Pessoa de Meia-Idade , Manifestações Neurológicas , Osteoartrite/tratamento farmacológico , Dor/tratamento farmacológicoAssuntos
Parassimpatolíticos/farmacologia , Tropanos/farmacologia , Acomodação Ocular/efeitos dos fármacos , Adolescente , Adulto , Atropina/administração & dosagem , Atropina/farmacologia , Pressão Sanguínea/efeitos dos fármacos , Feminino , Humanos , Injeções Intravenosas , Pulso Arterial/efeitos dos fármacos , Salivação/efeitos dos fármacos , Escopolamina/administração & dosagem , Escopolamina/farmacologia , Estatística como Assunto , Supositórios , Sudorese/efeitos dos fármacos , Comprimidos , Fatores de Tempo , Tropanos/administração & dosagem , TuberculoseAssuntos
Síndromes de Imunodeficiência/complicações , Osteoartropatia Hipertrófica Secundária/diagnóstico por imagem , Adolescente , Bronquiectasia/complicações , Candidíase Mucocutânea Crônica/complicações , Candidíase Mucocutânea Crônica/imunologia , Criança , Feminino , Humanos , Masculino , Osteoartropatia Hipertrófica Secundária/etiologia , Pneumonia/complicações , Radiografia , RecidivaRESUMO
An 11 year old girl with retarded growth, recurrent infections, bronchiectasis, and normal serum immunoglobulin concentrations had a combined deficit of the IgG2 subclass and IgG and IgM specific antibodies. Immunoglobulin replacement was followed by clinical improvement. The importance of determining both IgG subclasses and antibody activity in patients with recurrent infections and normal serum immunoglobulin values is emphasised.
Assuntos
Disgamaglobulinemia/complicações , Deficiência de IgG , Infecções Respiratórias/etiologia , Criança , Feminino , Humanos , Imunoglobulinas/análise , Recidiva , Infecções Respiratórias/imunologiaRESUMO
The Paul-Bunnell test, now 50 years old, is still of fundamental importance in the diagnosis of infectious mononucleosis, even though various immunologic methods have been developed in clinical practice to identify constituents of the Epstein-Barr virus (EBV). The demonstration of sheep red cell agglutinins in infectious mononucleosis (Paul-Bunnell) was in fact the first observation of the presence of heterophil antibodies in this viral disease which was later shown to evoke a polyclonal antibody response to a wide spectrum of autoantigens as well. The selective tropism of EBV for B lymphocytes and the reactivity of T lymphocytes to these infected B lymphocytes are the pathophysiological elements characteristic of infectious mononucleosis, and are the reason for this massive antibody response.
Assuntos
Mononucleose Infecciosa/imunologia , Anticorpos Heterófilos , Anticorpos Antivirais/análise , Artrite Reumatoide/etiologia , Autoanticorpos , Linfócitos B/imunologia , Linfócitos B/microbiologia , Linfoma de Burkitt/etiologia , Transformação Celular Viral , Feminino , Herpesvirus Humano 4/imunologia , Humanos , Síndromes de Imunodeficiência/complicações , Mononucleose Infecciosa/complicações , Mononucleose Infecciosa/epidemiologia , Doenças Linfáticas/etiologia , Ativação Linfocitária , Masculino , Linfócitos T Reguladores/imunologiaRESUMO
In 104 children with atopic dermatitis (AD) and RAST tests for 2 inhalant and 9 food allergen mixtures, RAST results, severity of skin involvement and presence of respiratory symptoms by history were analyzed in addition to total serum IgE values available in 66 children. Overall frequency of sensibilization was high (74%) with more positive RAST results for foods than inhalants, although of the latter the only two tested were among the more frequently positive. When the subjects positive for inhalants were considered alone, the frequency of respiratory symptoms was significantly higher in those sensitized to both inhalant mixtures tested (dermatophagoides and graminaceae) and the presence of more severe skin lesions was more common among those sensitized to graminaceae.
Assuntos
Alérgenos , Dermatite Atópica/etiologia , Hipersensibilidade Respiratória/etiologia , Criança , Dermatite Atópica/imunologia , Feminino , Hipersensibilidade Alimentar/etiologia , Hipersensibilidade Alimentar/imunologia , Humanos , Imunoglobulina E/análise , Masculino , Teste de Radioalergoadsorção , Hipersensibilidade Respiratória/imunologiaRESUMO
Two cases of visceral leishmaniasis in children are described. In both "in vitro" lymphocyte response to mitogens and allogeneic cells was initially markedly depressed, but returned to normal within a few days after six days of treatment with N-methylglucamine antimonate; in one the candidin skin test reverted from negative to positive after treatment and in the other a circulating serum factor was found which strongly inhibited phytohemagglutinin--and mixed--responsiveness of normal lymphocytes, but disappeared after therapy.
Assuntos
Hipersensibilidade Tardia/imunologia , Leishmaniose Visceral/imunologia , Amino Açúcares/uso terapêutico , Antimônio/uso terapêutico , Pré-Escolar , Feminino , Humanos , Terapia de Imunossupressão , Ativação Linfocitária , Masculino , Testes CutâneosRESUMO
Fifty children with IgA deficiency were folllowed for 1 to 4 years from 1975 to 1978. Thirty-five had complete deficiency of serum IgA (less than 2.5 IU/ml) and 15 partial deficiency (serum IgA below the 10th centile for age). Patients with another associated immunodeficiency, such as ataxia-telangiectasia, were not included. Most children with complete deficiency of IgA had recurrent respiratory and/or gastrointestinal infections, about half with onset in the first year of life, while partial deficiency of IgA has probably little if any importance for anti-infectious immunity but is important in the pathogenesis of atopy. Atopic diseases were frequent in both groups. Chromosomal abnormalities were found in 2 patients: trisomy 21 in one and in the other a ring chromosome 18. No important defects in cellular immunity were detected but some isolated, borderline abnormalities were often present.
Assuntos
Disgamaglobulinemia/imunologia , Deficiência de IgA , Criança , Pré-Escolar , Aberrações Cromossômicas/imunologia , Transtornos Cromossômicos , Cromossomos Humanos 16-18 , Síndrome de Down/imunologia , Feminino , Gastroenterite/imunologia , Humanos , Imunidade Celular , Imunoglobulina A/análise , Lactente , Masculino , Recidiva , Infecções Respiratórias/imunologiaRESUMO
Anti-streptolysin O (ASO) antibodies are an expression of the frequent encounters even during the first years of life with beta hemolytic Streptococci, they are easily measured by quantitative laboratory tests and so possess the characteristics of a screening test for impaired antibody production. We have assessed ASO titers in 1955 healthy subjects of different ages (range: 1 month to 97 years). The behaviour of ASO titer is extensively described in the text. The percentage of people with less than 10 TU titers is under 5% after the age of 5 years up to 15 years; from 15 to 60 years there are no subjects with undetectable ASO titer and after this age the percentage is still under 5%. It seems therefore advisable not to define a "normal" treshold when titrating these antibodies to avoid the risk of missing low antibody producers.
Assuntos
Antiestreptolisina/análise , Infecções Estreptocócicas/imunologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Formação de Anticorpos , Criança , Pré-Escolar , Humanos , Imunocompetência , Lactente , Pessoa de Meia-Idade , Infecções Estreptocócicas/sangueRESUMO
80 children with selective immunoglobulin A (IgA) deficiency--40 with severe deficiency (serum IgA less than 5 mg/dl) and 40 with partial deficiency (serum IgA greater than 5 mg/dl but less than minus 2 SD of the age-normal mean)--were followed up for 1.5 to 9 years; during which their serum and salivary IgA levels were measured periodically and the number and type of infections they had were recorded. In the partial deficiency group serum IgA rose to normal levels in half the group at a median age of 14 years and at a median time of 4 years after diagnosis, but they did not reach the normal range in the severe deficiency group. Pneumonia occurred more frequently in the severe than in the partial deficiency group. In addition, 11 of the 12 severely IgA deficient patients who had pneumonia had levels of both serum and salivary IgA of less than 0.5 mg/dl, and only 1 had detectable serum IgA levels. These data indicate that in childhood severe IgA deficiency is persistent and predisposed to pneumonia, whereas partial IgA deficiency is often transient and only occasionally associated with pneumonia.
Assuntos
Disgamaglobulinemia/etiologia , Deficiência de IgA , Doença Aguda , Adolescente , Fatores Etários , Criança , Pré-Escolar , Disgamaglobulinemia/imunologia , Feminino , Seguimentos , Humanos , Imunoglobulina A/análise , Imunoglobulina G/análise , Imunoglobulina M/análise , Lactente , Masculino , Pneumonia/etiologia , Pneumonia/imunologia , Saliva/análiseRESUMO
Analysis of 330 exostoses in 18 patients affected by hereditary multiple exostoses disease suggested a new classification of exostoses as eccentric or full-thickness. Radiographically arrest of metaphyseal remodeling with failure of coning and persistence of the primary metaphyseal trabeculae was evident in full-thickness exostoses. Similar bone lesions can be obtained experimentally with inhibitors of bone turn-over. A localized, peripheral defect in remodeling over a limited time can give a satisfactory explanation also for the origin of eccentric exostoses. The thesis that this is the basic mechanism of exostosis formation is presented.
Assuntos
Exostose Múltipla Hereditária/diagnóstico por imagem , Adolescente , Adulto , Criança , Pré-Escolar , Exostose/fisiopatologia , Exostose Múltipla Hereditária/genética , Exostose Múltipla Hereditária/fisiopatologia , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Linhagem , RadiografiaRESUMO
A double blind vs placebo study was carried out to study the effect of letosteine on the symptoms and clinical course of paediatric patients suffering from acute febrile bronchitis. Forty children were recruited for the research: 20 were treated with letosteine in a dose of 25 mg x 3 g/die and 20 with placebo; treatment lasted 10 days. The following parameters were assessed during the trial: body temperature, cough, thoracic objectivity, respiratory function indices. The results of the study show that in the letosteine treated group there is a statistically significant decrease in fever, a favourable evolution of thoracic objectivity and an improvement in certain respiratory function parameters (MEF 75, PEF). It is concluded that treatment with letosteine leads to a significant increase in the rate of regression of thoracic symptomatology and a faster, more substantial reduction in fever in children suffering from acute bronchitis. This is probably the result of drug action on mucus viscosity, restoring optimal mucociliary clearance, and through action fostering the penetration of antibacterial substances into the mucus.
Assuntos
Bronquite/tratamento farmacológico , Expectorantes/uso terapêutico , Tiazóis/uso terapêutico , Doença Aguda , Bronquite/complicações , Bronquite/fisiopatologia , Broncospirometria , Criança , Pré-Escolar , Ensaios Clínicos como Assunto , Método Duplo-Cego , Avaliação de Medicamentos , Feminino , Febre/etiologia , Humanos , Masculino , TiazolidinasRESUMO
In 113 children with atopic dermatitis RAST results for 9 food mixtures were analyzed. Sixty-eight children (60%) were RAST positive (greater than or equal to ++) for one or more mixture and 87% of those RAST positive had specific IgE for egg and/or cereals and/or legumes. Sensitization to egg, cow milk and meat was more frequent in the first years of life. RAST for the mixture of cereals and each single cereal, performed in 37 children, gave concordant results in 76%; agreement for the positive results was 88%, but only 54% for the negative ones. Breast versus cow milk feeding in the first months of life was not found to affect intensity of the skin manifestations or frequency of RAST positivity for the food mixtures or the respiratory symptoms.